Mental Health Effexor not working as well as hoped - tricyclics next??

[JohnBoy2000]

Been through ssri's, prozac and lexapro - nothing.

Then effexor - helped with IBS but still uncomfortably present.
Slight help with sleep.

But chronic fatigue still right there, can only get very little done in the day.

225mg for two weeks now, after 150 for 8 weeks.

I thought the dose increase would yield significant improvement, but it hasn''t yet, at least.

Also on 45 mg mirtazipine which I love, cause it helps me sleep, and helps me eat - my appetite sucks also.

Anyways - MAOI's, apparently are very difficult to take due to restrictions.

Tricyclics seem to be the next step.

Do they require dosing multiple times per day or what?

Any particular one that stands out?

I've seen Amitryptiline, prothiaden and surmontil.

Any insights??

I'm told that carry some more side effects, but could have greater efficacy - blurred vision, fatigue etc.
Can they be taken with mirtazipine??

 

[sekio]

NSPD is not really a diagnosis/medication consultation board, I'm going to move this to OD.

For what it's worth, tricyclics are a good option to try when SSRIs don't work. I think the mirtazepine can interact with them to intensify their effects (and vice versa), though, so that's really something you need to be asking your doctor.

 

[AlphaMethylPhenyl]

Tricyclics aren't really prescribed that much (except for something like doxepin, for sleep). They can be fairly dangerous, and tend to impair thinking because they're antichollinergics (they block acetylcholline, a chemical used in cognition).

MAOIs can be pretty dangerous too, but the general consensus is that the risk is overstated, so long as one can follow the restrictions.

 

[kleinerkiffer]

Od -> mh

 

[paranoid android]

Tricyclics seem to be the only anti-depressants sides Bupropion that i can tolerate and actually work. I have Bipolar disorder and most other anti-depressants either make me manic as fuck or do nothing. I have taken both Amitriptyline and Trimipramine and i would have to say that the Trimipramine worked possibly better then the Bupropion and also helped my sleep quite abit. As Tricyclics can be rather sedating depending on which one your talking about due to the anti-cholinergic and Anti-histaminic effects they can add to the sedation of Mirtazapine. Also as many of them act as Norepinephrine reuptake inhibitors as well as Serotonin reuptake inhibitors they could possibly interact with a Norepinephrine and Serotonin enhancer like Mirtazapine but i am not sure. I know they mix Effexor a SNRI with Mirtazapine sometimes and Amitriptyline is basically a SNRI with effects on other receptors like the Muscarinic and H1 receptor it could be safe. Either way ask your doctor about it they are worth trying imo

 

[Elis D]

Effexor (Venlafaxine) is an SNRI (selective norepinephrine reuptake inhibitor) and i take the same thing but i dont think it does a damn thing for me unless i miss a dose and get electric shocks and it feels like my brain is hitting the inner sides of my head. This can happen after missing just one dose with SNRIs.
I hate SSRIs and anti-depressants in general as i went through most of them when i was a teen a swore never to go back on them again. However towards the end of last year my life turned to shit and i became highly suicidal with a couple massive attempts each time OD witgmh 18,000mgs of quetiapine but was found each time and now have some permanent bd from those two episodes. So I figured I had nothing too loose and had never taken an SNRI before so tried a couple of them with no effects whatsoever exxept WD when I stopped or missed a dose or two. Effexor definitely will not work on me now as i am on 32mgs of Suboxone a day and this just negates all effects but I'm still not that well and am on a benzodiazepine WD tapering program so I don't want to mess around with stopping it now.
Back too the question, doctors these days will very rarely prescribe any tricyclic or MAOIs due to there side effects.
I couldn't really see any doctor prescribing any amitryptaline along with low doses if mirtazipine if at all. Amitryptaline is mainly prescribed for sleep these days and low doses of mirtazipine are sedative with higher doses being for anxiety, less is more with mirtazipine.
Have you tried any other SNRIs? I think there are only three different kinds.
Good luck bro and hope you find the help with the right meds.

P.S Ever tried Modafinil to help with chronic fatigue syndrome? Not that I have CFS but Modafinil works wonders!